RubinBrown Team Member Manual

POLICY CONTINUED Policy Title: Policy Number:

Section: COBRA – Continuation of Medical & Dental Coverage 403 Employee Benefits

You must make sure that you provide a copy of the SSA’s disability determination to the Plan Administrator prior to the last day of the initial 18-month COBRA continuation coverage period AND within 60 days of the latest of the dates listed below: • the date the qualified beneficiary was informed (through the Summary Plan Description (SPD) or Initial General Notice of COBRA Rights) of the responsibility and procedures for informing the plan of the disability determination;

• the date on which the qualifying event occurred; • the date coverage was lost (or would be lost); or • the date the SSA made their determination (date of the determination notice of award).

Second qualifying event extension of 18-month period of continuation coverage: If, while receiving COBRA continuation coverage, your spouse and/or dependent child(ren) experiences another qualifying event which causes a loss of coverage, they can get up to 18 additional months of COBRA continuation coverage, for a total of up to a maximum of 36 months from the date of the first qualifying event. This extension is available only to the spouse and dependent children if the employee or former employee dies, becomes entitled to Medicare benefits (under Part A, Part B, or both), or gets divorced or legally separated, or if the dependent child stops being eligible under the Plan as a dependent child, but only if the event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred. In all of these cases, you must make sure that the Plan Administrator is notified of the second qualifying event within 60 days of the second qualifying event. If You Have Questions: COBRA continuation coverage laws are administered by several agencies. The Departments of Labor and the Treasury have jurisdiction over private-sector group health plans. The Department of Health and Human Services administers the continuation coverage law as it affects State and local government health plans. The Labor Department's interpretive responsibility for COBRA is limited to the disclosure and notification requirements of COBRA. The Labor Department has issued regulations on the COBRA notice provisions. The Treasury Department has interpretive responsibility to define the required continuation coverage. The Internal Revenue Service, Department of the Treasury, has issued regulations on COBRA provisions relating to eligibility, coverage, and payment. The Departments of Labor and the Treasury share jurisdiction for enforcement of these provisions. Resources: If you need further information about COBRA, ERISA, HIPAA, or ACA, contact the Employee Benefits Security Administration (EBSA) electronically at www.askebsa.dol.gov or call toll free 1-866-444-3272. For information about the interaction of COBRA and HIPAA, visit the EBSA Web site, go to "Publications and Reports", and click on Health Benefits Coverage Under Federal Law. The Centers for Medicare and Medicaid Services offer information about COBRA provisions for public-sector employees. You can write them at this address: Centers for Medicare and Medicaid Services 7500 Security Boulevard Mail Stop C1-22-06 Baltimore, MD 21244-1850

RUBINBROWN TEAM MEMBER MANUAL | 39